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Incremental Net Benefit of COVID-19 Booster Vaccination: A Systematic Review and Meta-Analysis
Kwame Kissi-Twum1, Jeong-Yeon Cho1, Dziedzom Kwesi Awalime2
1Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT, USA.
Value in Health Regional Issues
|April 29, 2026
Summary
Annual COVID-19 messenger RNA booster vaccination is cost-effective for the general population from a societal viewpoint. This analysis provides crucial economic data for public health decisions regarding vaccine boosters.
Area of Science:
- Public Health
- Health Economics
- Infectious Disease Epidemiology
Background:
- Booster vaccinations for COVID-19 are recommended to sustain immunity.
- Limited cost-effectiveness data exists for COVID-19 booster programs.
- This study addresses the economic value of booster vaccinations.
Purpose of the Study:
- To quantitatively synthesize the incremental net benefit (INB) of COVID-19 booster vaccinations.
- To evaluate the cost-effectiveness of different COVID-19 booster strategies.
Main Methods:
- A systematic meta-analysis of cost-effectiveness studies identified through major databases (PubMed, Embase, EconLit, Tufts Registry) up to December 2024.
- Included studies reported cost per quality-adjusted life-year for mRNA or adapted COVID-19 boosters versus primary series or no boosters.
- Pooled INBs using a random-effects model, stratified by country income, vaccination frequency, study perspective, and age-risk groups; bias and heterogeneity were assessed.
Main Results:
- Seven studies were meta-analyzed. Annual booster vaccination showed significant cost-effectiveness from a societal perspective in the general population (INB: $210).
- Cost-effectiveness was not significant from a payer perspective for the general population (INB: $45).
- Results varied for high-risk and mixed-risk groups, with cost-effectiveness observed only from a payer perspective in the mixed-risk group.
Conclusions:
- Annual mRNA COVID-19 booster vaccination is cost-effective for the general population from a societal perspective.
- Findings support informed decision-making for booster vaccination policies, especially where local data is scarce.
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